Graves disease, RAI and gastric bypass

I'm 26 years old, the first time I looked into gastric bypass I was 20. I went to the seminars, did all I had to do before my insurance denied me. At the time I started they told me it was covered under my plan, then after the paperwork was submitted the lady from the insurance called back and said she misspoke, my type of insurance didn't cover it but other plans they had did. I now have great insurance that does cover!

At age 21, I was diagnosed with Graves disease, but caught it early as I had labs in febuary and they were normal and then in November I was hyper. I underwent radio active iodine the next febuary, since my endocrinologist told me it was my only hope of having children in next few years. (5 years later still no children, been trying for 3 years)

Anyways, my thyroid reached hypo 3 months after rai and went in normal range a year after rai. They were normal for awhile, then I went hypo again my doctor tweaked and tweaked and now I'm hyper in free t4 and normal in tsh and now for some more tweaking.

Has anyone been hyper and had rai? And I'm worried I won't be a candidate for surgery since my levels won't balance out. I feel fine, no issues besides the being tired a lot but I also blame that on my hectic job schedule and the workaholic part of me loves money and overtime.

So if you did RAI, the after effect is that you are supposed to go hypo. Very, very few people do rai and end up just normal-- you end up hypo and must take replacement hormone (like synthroid).

i had Graves' disease- a very severe case of it (all prior to WLS). I did rai and it didn't even work- was still hyper, complete with symptoms. I did aTotal thyroidectomy, so will forever be hypo-- but take synthroid to level me out. 

Hormone levels take a while to catch up with changes in meds. I think what's more important is if you are having symptoms. My symptoms were racing heart, short of breath, Diarrhea weakness, shaky hands, and weight loss. No way would I have been approved for WLS surgery in the state I was in. But if you are asymptomatic, I'd at least have the discussion to see if surgery can be done- with close monitoring of symptoms and levels. 

I take a much higher dose of synthroid then my weight dictates I need (it's prescribed based in weight) but the malabsorption effect of RNY seems to fend off me have too much replacement hormone.

my thyroidectomy was 3/2014, WLS 4/2015 neither have been an issue. 

I did go hypo after rai. Then when my thyroid was stable I was on 150 mcg. Then I started getting really really tired and migraines, had it checked and it was low so she increased my levothyroxine. She increased it so much I'm now hyper and had to decrease it.

I had severe case of hypo and meds are not weight-based. I am currently on 250 mcg Levo daily. I was pretty unstable with high tsh yrs and could not lose at. In most people with my case, hypo will reduce abilities to lose weight and no matter what I did my low was 217. I think if you have documented proof that they are trying to maintain you as best with a normal tsh then you may be ok, but they do try to rule out due to the instability as a cause. My hasband had a very bad case of graves and had RAI about 13 years ago due to decreased lymphocytes. He is overweight, not bad but dose is 137 mcg and he works out hard every day. Just try to get it as close to normal as possible.

Excerpted from Thyroid Disease: Understanding hypothyroidismand hyperthyroidism, Copyright ©2012, Harvard University.

Your initial dose of thyroid medication is carefully selected based on your weight, your age and whether you have any other medical conditions. A general guideline is 0.8 mcg for every pound of weight (or 1.6 mcg for every kilogram of weight). But your doctor may decide on a lower or higher dose depending on your individual cir****tances.